胫腓骨骨折三种固定方式的临床疗效比较

Comparison of Therapeutic Effects on Tibial and Fibular Fracture with Three Different Fixation Methods

目的比较3种固定方法治疗胫腓骨骨折的疗效。方法分别采用外固定支架、AO加压钢板、交锁髓内钉治疗胫腓骨骨折患者,对比其疗效。结果随访6～24个月,平均16个月。外固定支架组与交锁髓内钉组疗效间差别有统计学意义(P<0.05),加压钢板组与交锁髓内钉组疗效间差别有统计学意义(P<0.05),外固定支架组与加压钢板组疗效间差别无统计学意义(P>0.05)。交锁髓内钉组和其余两组并发症发生率间差别有统计学意义(P<0.05)。结论交锁髓内钉可广泛应用于闭合性胫腓骨复杂骨折,且优于AO钢板及外固定支架,术后骨折愈合较为理想。AO钢板应慎用于胫骨中下1/3段复杂闭合性骨折,外固定支架对于开放性骨折是上述方法的补充。

Objective To compare therapeutic effect of tibial and fibular fracture on the use of three different fixation methods. Methods From December 1998 to December 2007. 354 cases of tibial and fibular fracture received treatment of different methods were analyzed retrospectively. Among them, 141 cases were treated with external fixator, 111 cases AO compressed steel plates and 102 cases intramedullary interlocking nail. Results AII cases were followed - up for 6 - 24 months, average followed - up period were 16 months after operation. The rate of excellence and good were 80. 8% in external fixator. 72. 9% in AO compressed steel plates and 94. 1% in intramedullary interlocking nail respectively. Conclusion The rapeutic effect of tibial and fibulal fracture treated by intramedullary Interlocking nail is more satisfied than by external fixator and AO compressed plates. The intramedullary interlocking nail was considered as an effective means of treatment of tibial and fibulal fracture with little hurt of operation, good anatomy reposition, high rate of fracture heaing, early function exercise and rare complications. It should be careful that the fracture of 1/3 middle and lower segment of the tibia Was treated by AO plate. The exterior external fixator were an additional mean in treating opened fracture.